DR. Thomas Love Prendergast

NPI #1124124821 in Fox Lake, Illinois

Provider Information

NPI Number: 1124124821
Entity Type: Individual
Name: DR. Thomas Love Prendergast
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist
Enumeration Date: Sep 16, 2006
Last Updated: Sep 19, 2014

Practice Location

Address: 1394 S ROUTE 12
City: Fox Lake
State: Illinois
ZIP Code: 60020-1949
Phone: (847) 587-5053

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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